&lt;p&gt;Idiopathic epiretinal membrane surgery: safety, efficacy and patient related outcomes&lt;/p&gt;

Iuliano, Lorenzo; Fogliato, Giovanni; Gorgoni, Francesca; Corbelli, Eleonora; Bandello, Francesco; Codenotti, Marco

doi:10.2147/opth.s176120

Cited by 35 publications

(43 citation statements)

References 92 publications

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“…Although metamorphopsia and visual impairment could be improved in approximately 70–90% of postoperative ERM cases ( De Bustros et al, 1988 ; Iuliano et al, 2019 ), these symptoms persist in some ERM patients. Predicting postoperative outcomes and weighing the risks and benefits of surgery are important because there are currently no standardized surgical indicators for ERM ( Diaz-Valverde & Wu, 2018 ; Nakashizuka et al, 2019 ).…”

Section: Discussionmentioning

confidence: 99%

Association between individual retinal layer thickness and visual acuity in patients with epiretinal membrane: a pilot study

Zou

Tan

Huang

et al. 2020

PeerJ

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Purpose We investigated the correlation between visual acuity (VA) and individual retinal layer thickness in the foveal, parafoveal, and perifoveal regions of patients with an idiopathic epiretinal membrane (ERM). Methods One hundred and five subjects presenting with unilateral idiopathic ERM were included in this study. We segmented each patient’s optical coherence tomography (OCT) image into seven layers and calculated the mean layer thickness in the foveal, parafoveal, and perifoveal regions using the Iowa Reference Algorithm. In 105 patients with ERM, we detected correlations between their macular regions’ individual retinal layer thickness and their best corrected VA. Thirty-one of the 105 patients with ERM underwent vitrectomy and completed six months of follow-up. We then compared the 31 surgical patients’ preoperative and postoperative individual retinal layer thickness in each macular region. Additionally, the association between preoperative individual retinal layer thickness in each macular region and VA six months post-surgery in patients with ≥ two Snellen lines of visual improvement was determined. Results Multiple linear regression analysis showed that the inner nuclear layer (INL) thickness in the foveal, parafoveal, and perifoveal region were all associated with VA in the 105 patients (R2 = 0.344, P < 0.001; R2 = 0.427, P < 0.001; and R2 = 0.340, P < 0.001, respectively). Thirty-one surgical patients 6 months post-surgery showed significantly decreased thicknesses (P ≤ 0.012) of the foveal INL, inner plexiform layer (IPL), and outer nuclear layer (ONL); the parafoveal retina nerve fiber layer (RNFL), IPL, INL, and ONL; and the perifoveal RNFL, IPL, INL, ganglion cell layer (GCL), outer plexiform layer (OPL), and photoreceptor layer (PRL). We found a weak correlation between postoperative VA and preoperative foveal and perifoveal RNFL thickness (r = 0.404 and r = 0.359, respectively), and a moderate correlation between postoperative VA and preoperative foveal and parafoveal INL thickness (r = 0.529 and r = 0.583, respectively) in the 31 surgical patients (P ≤ 0.047). The preoperative INL thickness in the foveal, parafoveal, and perifoveal regions showed a moderate to strong correlation (r = 0.507, 0.644, and 0.548, respectively), with postoperative VA in patients with ≥ 2 lines of visual improvement (P ≤ 0.038). Conclusion We detected a correlation between retinal damage and VA in the parafoveal, perifoveal, and foveal regions. Our results suggest that INL thickness in all macular regions may be a prognostic factor for postoperative VA in ERM patients.

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Section: Discussionmentioning

confidence: 99%

Association between individual retinal layer thickness and visual acuity in patients with epiretinal membrane: a pilot study

Zou

Tan

Huang

et al. 2020

PeerJ

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“…Numerous studies have reported OCT measurements which correlate to visual prognosis, with attempts at incorporating such biomarkers into newer ERM classification systems. Features on OCT predicting a better prognosis include: absence of EIFL, 90‐92 inner retinal irregularity, CMO 93 or acquired vitelliform lesions 89 ; preserved integrity of the EZ 83,93,94 and COST 94 ; and thinner CFT and preoperative ganglion cell layer‐inner plexiform layer (GCL‐IPL) 95,96 …”

Section: Investigationsmentioning

confidence: 99%

“…In addition, OCT imaging has provided insights into post‐surgical retinal damage which can occur, particularly with ERM/ILM double peeling. However, there is little evidence that postoperative changes on SD‐OCT are linked to poorer VA or even changes on microperimetry 95 …”

Section: Managementmentioning

confidence: 99%

Epiretinal membrane: A review

Fung

Galvin

Tran

2021

Clinical Exper Ophthalmology

101

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The prevalence of epiretinal membrane (ERM) is 7% to 11.8%, with increasing age being the most important risk factor. Although most ERM is idiopathic, common secondary causes include cataract surgery, retinal vascular disease, uveitis and retinal tears. The myofibroblastic pre‐retinal cells are thought to transdifferentiate from glial and retinal pigment epithelial cells that reach the retinal surface via defects in the internal limiting membrane (ILM) or from the vitreous cavity. Grading schemes have evolved from clinical signs to ocular coherence tomography (OCT) based classification with associated features such as the cotton ball sign. Features predictive of better prognosis include absence of ectopic inner foveal layers, cystoid macular oedema, acquired vitelliform lesions and ellipsoid and cone outer segment termination defects. OCT‐angiography shows reduced size of the foveal avascular zone. Vitrectomy with membrane peeling remains the mainstay of treatment for symptomatic ERMs. Additional ILM peeling reduces recurrence but is associated with anatomical changes including inner retinal dimpling.

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“…However, increased comorbidities were the primary consideration in most areas, especially the Eastern region. Surgery for ERMs is important to improve patients' longterm visual condition (13). The peeling of ILM is applied as an accessory procedure to improve the curative effect, (14) and results in a lower recurrence rate (15).…”

Section: The Choice Of Conservative Treatment Versus Erm Surgerymentioning

confidence: 99%

Geographic variations in idiopathic epiretinal membranes in China

Xu¹,

Zhou²,

Sun³

et al. 2021

Ann Transl Med

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Background: Idiopathic epiretinal membranes (ERMs) often cause metamorphopsia and the progressive loss of central visual function, which seriously affect quality of life. We aimed to map the distribution pattern of idiopathic ERMs in China and to examine the factors affecting the surgical choices of multicenter surgeons.Methods: A national ophthalmologist-oriented questionnaire was administered, applied with a multistage probability sampling method. Data of essential characteristics, including age, professional title, residence, and perioperative and postoperative care, were gathered. All the data are expressed as odds ratios (ORs) and 95% confidence intervals (CIs). The histogram and choropleth map were generated by Excel 2016.Results: In total, 1,137 (85.2%) valid responses were returned with maximized response and completion rates. The study showed that monthly admission numbers, and preoperative and postoperative care varied significantly across different regions in China. Generally, the monthly patient admission numbers were lower in the Western region than the Eastern region. However, patients in the Eastern region had longer preoperative waiting periods and shorter hospital stays. Conclusions:The epidemiology of idiopathic ERMs varied significantly across different regions in China.The distribution pattern of ERM in China and the overview of the factors affecting the surgery approaches of multicenter surgeons were shown. The findings of this study will contribute to the formulation of medical policies, and provide insights into the healthcare environments across China.

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<p>Idiopathic epiretinal membrane surgery: safety, efficacy and patient related outcomes</p>

Cited by 35 publications

References 92 publications

Association between individual retinal layer thickness and visual acuity in patients with epiretinal membrane: a pilot study

Association between individual retinal layer thickness and visual acuity in patients with epiretinal membrane: a pilot study

Epiretinal membrane: A review

Geographic variations in idiopathic epiretinal membranes in China

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